Early initiation of noninvasive positive pressure ventilation, along with short acting β-agonists and systemic steroids, can be safe, well-tolerated, and effective in the management of children with status asthmaticus.

Many infants are exclusively fed unmodified goat's milk as a result of cultural beliefs as well as exposure to false online information. Anecdotal reports have described a host of morbidities associated with that practice, including severe electrolyte abnormalities, metabolic acidosis, megaloblastic anemia, allergic reactions including life-threatening anaphylactic shock, hemolytic uremic syndrome, and infections. We describe here an infant who was fed raw goat's milk and sustained intracranial infarctions in the setting of severe azotemia and hypernatremia, and we provide a comprehensive review of the consequences associated with this dangerous practice.

This report is the first to describe coronary vasospasm, diagnosed by cardiac magnetic resonance imaging in an adolescent, resulting from marijuana abuse. A previously healthy 17-year-old male patient with severe chest pain, electrocardiographic changes, and urine test positive for cannabis, was diagnosed of having transient myocardial ischemia. The patient was discharged home and at this writing remains asymptomatic with a follow-up echocardiogram after 1 month showing normal left ventricular systolic function. Marijuana should be considered in the etiology of transient coronary vasospasm leading to myocardial ischemia in otherwise healthy adolescents. Cardiac magnetic resonance imaging is a safe and effective method for diagnosing coronary vasospasm.

We report a 4-month-old infant with torsade de pointes secondary to procainamide treatment. The infant presented with atrial flutter and converted to normal sinus rhythm with intravenous procainamide. Oral procainamide therapy was initiated as the infusion was tapered, and the patient subsequently developed incessant torsade de pointes. Once the proarrhythmia was recognized, procainamide was withheld, and intravenous magnesium was administered. The torsade de pointes resolved after one bolus of magnesium sulfate. An infusion regimen of magnesium was given until the procainamide and N-acetylprocainamide concentrations became undetectable. Intravenous magnesium should be administered to newborns with acquired torsade de pointes; dosing guidelines for its use are suggested.

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